As you probably know, there are two series of bonds. From the Disclosure document linked to via the Disclosure Documents Tab on the link you sent: Official Statement - FINAL OS NY ONEIDA CNTY LOCAL DEV CORP MOHAWK VALLEY HLTH SYSTEM SER 2019 (2.5 MB), we see bond's header...
The larger series is tax-exempt, which is advantageous for the high tax individuals who typically buy such investments.
The information you are looking for is contained in the more complete breakdown on page 13:
The Costs of Issuance and the accompanying footnote above describe the details of the fees associated with issuing the bonds. $9,670,738 is not a small amount of money, but probably fairly standard as a percentage (3.76%) of $256,679,980 in two bond series for a municipality hospital.
The total interest payments are shown on the following page (14) in a table running through the year 2049:
So, this would be $181,785,000 for series 2019A and $2,246,673 for series 2019B. As you say, this is "more important (expensive)" than the fees charged.
Interest and fees MVHS must pay to borrow $262.7 million municipal bonding totals...
That's $193.7 million of expense to borrow $262.7 million... which is 73.9%!
As far as the Default Risk, on page 32:
BB+ rated bonds are Stable, but not as good as A - AAA rated bonds (even U.S. Treasuries are only rated AA now, and they are considered the safest investments).
The County has a buyer of all the bonds already:
Risks to the bonds are described more fully in the Bondholders' Risks section on page Part II-I.
However, as noted at the end of this section:
At the end of a rather lengthy and important set of risk disclosures - which any investor should read - is a statement on bankruptcy (page Part II-8):
And it is usually the bondholders who take the hit, though they have seniority over some other equity holders (and stock holders if there were any, which there are not in this case)...
I hope that answers some of your questions, but really it is only a start and you or your legal representative should examine the document's provisions more closely.
Full Disclosure: I am neither a lawyer nor a tax or bond specialist and I only apply reasonable reading skills and experience (including having had bonds go belly-up myself) to this set of provisions.
I have been active in xxxxxx banking for about 10 years. I am also a building designer and developer of a potential major building project, xxxxxx.
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